Jonathan Cohn: Truman, LBJ, Obama

Those are the simple, elegant terms Lyndon Johnson used to describe Medicare on July 30, 1965, the day he signed it into law.

He said it at the side of Harry Truman, who was nearly 80 then. They were at the Truman Library in Independence, Missouri, where Johnson had come to pay homage. It was Truman who had waged the first serious campaign for national health insurance. Truman didn't succeed, but he'd launched a crusade that liberals would spend the next decade-and-a-half pursuing....

On Tuesday, President Obama will sign the Patient Protection and Affordable Care Act into law. And the same spirit will be in the air....

...[L]ike Medicare, this bill represents a monumental step forward. The numbers are impossible to ignore. More than 30 million additional people will have insurance; even those with sizable deductibles will have protection from the kind of ruinous financial liabilities they face now. There is no public plan--for now!--but there is extensive regulation, including requirements that insurers spend more money on actual patient care. What we spend on medical care isn’t going to plummet. But it won’t rise as fast as it might otherwise. And, over the long run, that can save a lot of money--particularly if we are smart enough to learn and adapt as we go....